Hospitalizations and Costs Due to Leptospirosis in Pernambuco: Analysis of a Preventable Burden to the Sus (2014–2024)

Leptospirosis is a globally relevant zoonosis caused by spirochetes of the genus Leptospira, transmitted through contact with water or soil contaminated with urine from infected animals, especially rodents. Its occurrence is intensified in contexts of social vulnerability, unplanned urbanization, and extreme climate events ‒ common factors in tropical regions such as Pernambuco. Although often underreported, the disease represents a condition of notable clinical severity. Analyzing its clinical-epidemiological outcomes and economic impact on Brazil’s Unified Health System (SUS) is essential to support public policies aimed at prevention and effective management, particularly in socially and environmentally at-risk areas. This study aimed to analyze the epidemiological, clinical, and economic profile of hospitalizations due to leptospirosis in Pernambuco between 2014 and 2024. Retrospective ecological study using secondary data from TABNET/DATASUS. Hospitalizations for leptospirosis (ICD-10: A27.0, A27.8, and A27.9) were analyzed, including number of admissions, deaths, mortality rate, average length of stay, and total cost, along with sociodemographic variables such as sex, race/color, age group, schooling, place of infection, and reporting region. A total of 2,284 hospitalizations were recorded in the period, predominantly among men (83%), individuals of mixed race (pardo) (70%), and those aged 20–59 years (70%). The anicteric form accounted for 76% of cases. The average hospital stay was 7.5 days, and the overall mortality rate was 9.02%, with 206 deaths. Total hospital costs were R$ 5,186,753.93, with the greatest impact in 2022 (R$ 1.3 million). The hospitalization peak occurred from May to July, representing 54% of annual cases. Recife accounted for 93% of notifications. Regarding the likely area of infection, 436 cases were household-related and 120 occupational, although 70% of records lacked this information. Leptospirosis remains a recurrent and costly condition for the SUS in Pernambuco, mainly affecting young men in urban areas during rainy months. Investments in sanitation, environmental control, and improved-quality notification are strategic to mitigate its impact.